Overview of GOC – One Year Later July 2006 Arlene F. Lee, Executive Director

1. Governor’s Office for Children “Promoting the well-being of Maryland's children” * Local Management Boards ~ SCYFIS ~ Systems of Care Overview of GOC – One Year Later July 2006 Arlene F. Lee,Executive Director

2. Governor’s Office for ChildrenFY06 Accomplishments • Re-established the Governor’s Office for Children and the Children’s Cabinetto: • provide better services for children, youth and families; • coordinate inter-agency state efforts; and • oversee the state/local partnership with the local management boards. • Mandated a Children’s Cabinet State Interagency Plan ensuring comprehensive and effective prevention, intervention and treatment services for children and families. • Re-codified the Local Management Boards (LMBs) with the General Assembly and increased LMB funding by 38% to maintain and expand local services for children.

3. Governor’s Office for ChildrenFY06 Accomplishments LMB Technical Assistance • Hired LMB TA staff and contracted with a consultant. • Completed revisions to the LMB Policies and Procedures Manual. • Reorganized the LMB TA and MT to better assist the LMBs and to move forward results-accountability processes. • Sponsored a Training of Trainers and Coaches workshop conducted by Mark Friedman, a nationally-known consultant. The workshop resulted in a cadre of 23 trainers and coaches that are available to assist with implementing the results accountability framework. • Held LMB/GOC Legislative Day on February 28, 2006, where Delegates, Senators and the Governor met with LMB directors and boards. • Provided technical assistance to those LMBs interested in establishing an Opportunity Compact in their jurisdiction.

4. Governor’s Office for ChildrenFY06 Accomplishments LMB Monitoring • Improved monitoring tools and protocol in an effort to enhance the monitoring function and LMBs’ understanding and compliance with requirements. • Conducted 16 monitoring site visits in the following jurisdictions: Somerset, Washington, Allegany, Charles, Kent, Talbot, Dorchester, Baltimore City, Carroll, Baltimore, Harford, Anne Arundel, Montgomery, Wicomico, Worcester, and Prince George’s. • Conducted 14 site visits in the following jurisdictions: St. Mary’s, Frederick, Queen Anne’s, Howard, Baltimore City, Cecil, Caroline, Baltimore, Calvert, Anne Arundel, Montgomery, Somerset, Prince George’s and Garrett. • Conducted 11 remediation site visits to the following jurisdictions: Somerset, Washington, Allegany, Charles, Kent, Talbot, Dorchester, Carroll, Harford, Wicomico, and Worcester.

5. Governor’s Office for ChildrenFY06 Accomplishments Systems of Care Initiatives • $500,000 was awarded to Baltimore City and Montgomery LMBs each to create wraparound pilot sites to serve community Medicaid-eligible youth utilizing a care management entity structure. • Received a SAMHSA Mental Health Transformation Grant , designed to facilitate changes in the way mental health services are administered. • All 24 jurisdictions received technical assistance and submitted Local Access Plans. • The Innovations Institute was created at the University of Maryland, Baltimore to provide technical assistance to the State and local agencies. • The Invitation to Negotiate (ITN) a Local Integrated System of Care was issued in May 2006 to the LMBs

6. Governor’s Office for ChildrenFY06 Accomplishments Single Point of Entry • Registration for Single Point of Entry sessions and submission of proposals were automated into SCYFIS. • Sessions were scheduled in different regions of the State to encourage potential providers to develop resources where they are needed most- four in Baltimore City, one each in Southern Maryland, Western Maryland and the Eastern Shore with 400 potential providers trained. • A special Single Point of Entry meeting was held for approximately 70 current providers in an effort to encourage the expansion of resources in Baltimore City. • Over 200 new and revised proposals were received with fewer than 15 sent to licensing agencies. • Thirty-three current providers requested expansions of existing programs and 15 were approved.

7. Group Homes Working to improve services for kids while addressing legitimate concerns of the community. Launched a toll-free group home hotline for community concerns (866‑718‑5496) and an On-line Directory that lists all group homes in the state. Reorganized DHR Licensing and Monitoring, increased DHR and DJS staff. Improved Licensing and Monitoring Coordination across departments. Working to expand capacity in underserved areas of the State, guided by a new multi-agency Resource Develop Plan. Developing an Outcomes Measurement Data System to determine the quality of services. Governor’s Office for ChildrenFY06 Accomplishments

8. Family Recovery Program Launched the Family Recovery Program in Baltimore City, aimed at reducing a child’s length of stay in foster care by providing intensive case-management and treatment services for the child’s substance-abusing parents. Part of the Maryland Opportunity Compact (joint venture including Annie E. Casey Foundation, Baltimore Safe and Sound) with private funding provided to jump start the transition from treatment to prevention services, with a pledge to redirect savings towards other prevention services Governor’s Office for ChildrenFY06 Accomplishments

9. Publications Governor’s Office for ChildrenFY06 Accomplishments • SB711 (2004): A study to determine, by county or multi-county region, the number of children in each type of out-of-home placement and the number and type of placements that should be available in each county or multi-county region. • Preliminary State Resource Plan: This plan is expressed in terms of three components: existing out of home placement and utilization data, goals and priorities, and action plans.

10. Publications JCR on Out-of-Home Placements and Family Preservation:A report on the numbers of children served and the costs associated with out-of-home placements, out-of-state placements and an evaluation of family preservation efforts. “Maryland’s Results for Child Well-Being:”A report on the eight results of child well-being and the indicators —Babies Born Healthy, Healthy Children, Children Entering School Ready to Learn, Children Successful in School, Children Completing School, Children Safe in their Families and Communities, Stable and Economically Independent Families, and Communities that Support Family Life. Governor’s Office for ChildrenFY06 Accomplishments

11. Publications HB 416(2004):Recommended changes to the Resources Directory for accurate and current information on licensed group homes. The report outlined the process by which group home license notification would be carried out. HB 1146(2004):A plan for a system of outcome evaluation for all children in out-of-home care. Outlined six goals that the system is meant to accomplish or allow for, including the monitoring of the care and treatment of children in out-of-home placements and establishing an evaluation system for program performance, including safety, quality, and effectiveness. The design and development of this system are ongoing. Governor’s Office for ChildrenFY06 Accomplishments

12. Information Technology Department Created a new IT department responsible for providing internal network and systems support to GOC staff, SCYFIS development and client-user support, and interagency support for state-wide collaborative IT efforts. The implementation of this group includes the following initiatives: The development and support of the Statewide Children, Youth & Families Information System (SCYFIS). Creation of an IT Department Structure and Support Model to help GOC staff members better support GOC goals and objectives. Development of an IT Strategy that integrates technical solutions and GOC initiatives. Governor’s Office for ChildrenFY06 Accomplishments

13. Three – Year Plan Developed consensus around future activities Governor’s Office for ChildrenFY06 Accomplishments

14. Governor’s Office for Children“Promoting the well-being of Maryland's children” * Local Management Boards ~ SCYFIS ~ Systems of Care VISION • Children’s Cabinet: All Maryland’s children are successful in life. • Governor’s Office for Children: Maryland will achieve child well-being through interagency collaboration and state/local partnerships. MISSION • The Children’s Cabinet, led by the Executive Director of the Governor’s Office for Children (GOC), will develop and implement coordinated State policies to improve the health and welfare of children and families. The Children’s Cabinet will work collaboratively to create an integrated, community-based service delivery system for Maryland’s children, youth and families. Our mission is to promote the well being of Maryland’s children.

15. Maryland’s Youth Policy Structure Inform and support the collective and specific work of the Children’s Cabinet; Promote the values, policies and practices that continually advance the wellbeing of Maryland’s children and families; Partner with LMBs to plan, coordinate and monitor the delivery of integrated services along the full continuum of care, and oversee the use of Children’s Cabinet interagency funds in accordance with policies and procedures established by the Children’s Cabinet; and Assist the Children’s Cabinet in the allocation of funds Joint Committee for Children, Youth and Families Coordinate State efforts to improve the health, education, safety, and economic well-being of children; Investigate factors that jeopardize the condition of the State's children; Recommend new laws, regulations, and budget priorities; Recommend remedies to interdepartmental inefficiencies in services; Inform the Legislature and the general public of issues concerning the special needs of children, youth, and families. Governor’s Office for Children (GOC) Children’s Cabinet Advisory Council For Children Local Management Boards (LMBs)

16. Maryland’s Youth Policy Structure Promote the vision of the State for a stable, safe, and healthy environment for children and families; Provide a regular forum for State agencies to coordinate policy recommendations for the Governor; and Prepare a Three-Year Children’s Plan establishing priorities and strategies for the coordinated delivery of services for children and families. Joint Committee for Children, Youth and Families Strengthen the decision-making capacity at the local level; design and implement strategies that achieve clearly defined results in a local 5-year strategic plan; maintain standards of accountability; Influence the allocation of resources; coordinate services to eliminate fragmentation and duplication of services; create an effective system of services that improve outcomes for all children, youth, and families. Governor’s Office for Children (GOC) Children’s Cabinet Advisory Council For Children Make recommendations for integrated children and family programs; coordinating with local governments, LMBs, and private groups Local Management Boards (LMBs)

17. Maryland’s Youth Policy Structure Chair: Executive Director GOC Members: Children’s Cabinet Representatives, Co-Chairs Joint Committee on Children, Youth and Families, LMBs, private citizens, family members, and Local agency representatives. Chair: Executive Director GOC Members: Secretaries of Budget, Health, Human Resources (Child Welfare), Juvenile Services, Education Joint Committee for Children, Youth and Families Governor’s Office for Children (GOC) Children’s Cabinet Local Directors of State Agencies (Juvenile Services, Health, Human Resources, Education), County Agencies, Youth, Community Members Advisory Council For Children Local Management Boards (LMBs)

18. Governor’s Office for Children“Promoting the well-being of Maryland's children” * Local Management Boards ~ SCYFIS ~ Systems of Care Planning Process: • Stakeholders' meetings throughout July, August and September. • One day planning session, September 29, 2005, with facilitators from the Forum for Youth Investment, the National Governor’s Association and the National Conference of State Legislatures

19. Governor’s Office for Children“Promoting the well-being of Maryland's children” * Local Management Boards ~ SCYFIS ~ Systems of Care Purpose: • Develop consensus around the role and responsibilities of the Governor’s Office for Children (GOC), for legislation, if necessary, and elements of the Three-Year State Plan. Planning items: • Role/responsibility of GOC • Stakeholder recommendations to the Children's Cabinet • Framework for the three year Children's Plan Product: • Report on Stakeholder Recommendations with action items

20. Refocusing on Results Results-based Accountability Decision-making: • What are we trying to achieve? • What does the data tell us? • What is the story behind the data? • What partners do we need? • What strategies work? • What is our action plan? Source: Mark Friedman, Trying Hard is Not Good Enough, Canada: Trafford (2005)

21. What Are We Trying to Achieve? Child Well-being Results

22. What Does The Data Tell Us? Result: Stable and Economically Independent Families Indicator: Out-of-Home Placements Description of the baselines: Number of placements have decreased by 9.4% for the 3rd year in a row; HOWEVER, annual costs have increased at the average annual rate of 5.9% with an increase of 8% from FY03 to FY04.

23. What Is the Story Behind The Data? Story Behind the Curve: • Increased Mental Health Costs • Increasing Numbers of Voluntary Placements • Increased Medical Assistance payments • Increased DJS Costs • From FY03 to FY04: • MHA Institutional Placements increased by 4.1% • ADAA Long-Term Care Placements increased by 19.3%

24. What Is the Story Behind The Data? The data dictates an operational model that is multi-disciplinary, community-based, family-centered, and client-directed- Integrated Systems of Care:

25. What Partners Do We Need? Children’s Cabinet (DBM, DHMH, DHR, DJS, DOD, GOC, MSDE) Advisory Council Governor’s Office for Children State Agencies and Partners* Local Management Boards* (DJS, DSS, HD, LSS) Local Agencies and Partners* Maryland's Families * Includes: families, advocates, community organizations and other partners

26. What Strategies “Work”? All Maryland's Children Will Be Successful in Life State Priorities Local Priorities Stable and Economically Children Enter School Babies Born Children Safe in Their Independent Families Ready to Learn Healthy Families and Communities Indicator: Indicator: Indicator: Indicator: Out of Home Placement Selected by Selected by Kindergarten Assessment (Work Sampling System) Local Planning Local Planning Strategy: Strategy: Strategy: Strategy: Systems of Care Community Partnership Early Care and Education Community Partnership Action Agenda Agreements Agreements Local Implementation: Local Implementation: Local Implementation: Local Implementation: Local Access Plans Locally Determined Locally Determined Leadership in Action Plans Wrap Around Pilots Performance Performance Performance Performance Measures Measures Measures Measures

27. What Strategies “Work”? Systems of Care Initiatives • Maryland’s Wraparound Model • Train all partners on key components required for successful and self-sustaining individualized plans of care. • Maximize state and federal dollars. • Implement Outcome Monitoring and Quality Assurance Tracking Systems. • Assess and cultivate readiness of future Wraparound sites. • Local Access Plans • Create single point of access in each local jurisdiction. • Foster the growth of family support organizations and other community-based services. • Reinvest deep-end dollars into prevention and early intervention.

28. What Is Our Action Plan? • 3 Year Children’s Plan Goal 1: Prevention Goal 2: Transition Age Youth/ Ready by 21 tm Goal 3: Build on Foundation: Systems of Care Initiatives and More for Maryland

29. What Is Our Action Plan? Goal One: Prevention

30. What Is Our Action Plan? Goal One: Prevention The Evolution of Prevention Concepts Source: Forum for Youth Investment

31. What is Our Action Plan? State Level Prevention : Children’s Cabinet Agencies’ Role in Prevention – By 2007, update Three-Year plan to include “prevention” role for each agency within core mission • Convene representatives and explore agencies’ current role in prevention • Identify prevention activities relative to core mission • Consider prevention roles: • Protect (correct) • Prevent • Promote/Prepare • Participate

32. What Is Our Action Plan? Prevention – SB882/HB870, Three-Year Children’s Plan The focus will be both on problem reduction and full preparation for adult roles and responsibilities by youth. The range of goals for youth should be: • Protecting them from harm (and providing logical consequences for youth when they harm society); • Preventing a range of negative outcomes, from drug abuse to gang involvement; • Promoting positive outcomes, such as academic success; and • Ensuring that youth are both fully prepared and fullyparticipating in their community in positive ways. Source: Forum for Youth Investment

33. What Is Our Action Plan? Prevention – SB882/HB870, Three-Year Children’s Plan • LMBs will convene parents, youth, and representatives of public and private agencies that have knowledge of and experience working with at-risk youth and families. • Assess the adequacy, availability, and accessibility of current community-based services that: • Prevent and divert entry and reentry into the juvenile system; • Provide alternatives to incarceration and institutionalization; • Prevent and divert criminal behavior; and • Increase personal responsibility and self-sufficiency. • Identify neighborhoods or communities with critical needs and significant numbers of at-risk or delinquent youth and recommend programs that can be established or enhanced to address the unmet needs of youth and their families.

34. What Is Our Action Plan? Prevention – SB882/HB870, Three-Year Children’s Plan • The LMB will develop a request for funds to the Children’s Cabinet to award funds to local agencies or organizations to provide direct services; • Monitor and evaluate program performance; • Provide technical assistance to local programs as needed; • Promote cost-effective strategies; • Measure program outcomes; and • Provide quarterly fiscal and program reports to GOC.

35. What is Our Action Plan? Coordinate Gang Prevention Funding: • Joint Chairman’s Report Requires DJS to administer funding for programs that “provide gang prevention education or alternative activities to children at-risk of being drawn in to gang related violence and crime.” • Combine these DJS gang prevention funds with the prevention funding in the Children’s Cabinet fund in order to respond to prevention/youth development planning by the LMBs as part of SB 882

36. What Is Our Action Plan? Goal Two: Ready by 21tm • Ready for College • Ready for Work • Ready for Life Source: Forum for Youth Investment

37. What Is Our Action Plan? Goal Two: Transition Age Youth How many young people are ready? Researchers Gambone, Connell and Klem estimate that • 43% of youth are doing well in their early 20’s, but • 22% are having difficulty. Source: Forum for Youth Investment

38. What Is Our Action Plan? Goal Two: Transition Age Youth What does it mean to be Ready? Doing well in two life areas and ok in one. • Attending college or working steadily. • Have good health, good health habits, healthy relationships. • Volunteer, be politically active, be active in religious institutions, community. Source: Forum for Youth Investment

39. What Is Our Action Plan? Goal Two: Transition Age Youth What does it meant to NOT be Ready? Doing poorly in two life areas and not well in any . • Have HS diploma or less, be unemployed, on welfare. • Have poor health, health habits, unsupportive relationships. • Commit an illegal activity about once a month. Source: Forum for Youth Investment

40. What Is Our Action Plan? Goal Two: Transition Age Youth • With the support of the Annie E. Casey Foundation, the Forum for Youth Investment and the Fiscal Policy Studies Institute use the Leadership in Action Program (LAP) to develop a “Ready by 21 tm” strategy for youth between 18 and 21 years old. • LAP is an innovative and collaborative approach to leadership development that works with government, nonprofit, and community leaders, the program models a results framework that both uses—and teaches the use of—data to drive decision-making, aligns collective vision and action with measurable outcomes, and expects both immediate results while laying the foundation for long-term gains.

41. What Is Our Action Plan? Goal Two: Transition Age Youth • Identifying the youth well-being result; • Identifying indicators to measure this result and creating baselines and forecasts for the primary indicators; • Identifying the story behind the baseline and “what works” to improve the result; • Developing specific goals, strategies and implementation plans to achieve the result; and • Developing an on-going process of accountability.

42. What Is Our Action Plan? Goal Three: Building on Foundations

43. What Is Our Action Plan? Goal Three: Building on Foundations Entering School Ready to Learn

44. What Is Our Action Plan? Goal Three: Building on Foundations Entering School Ready to Learn Fully Ready Composite Score: Trend line and Targeted Improvement

45. What Is Our Action Plan? Goal Three: Building on Foundations Interagency Collaboration and Integrated Systems of Care

46. What Is Our Action Plan? Goal Three: Building on Foundations More complex needs Wrap Around 2-5% Resource Development Family Navigators 15% Single Point of Access Continuum of Care 80% Less complex needs Local Management Boards- DJS, DSS, HD, LEA, families, advocates, local government, community partners

47. What Is Our Action Plan? Goal Three: Building on the Foundations Supporting State and Local Priorities • Increase LMB Administrative Funding. • Invest in “front end” of local integrated system of care: single point of access and family navigators. • Increase investment in Wrap Around Maryland with new pilot sites and current sites. • Establish incentive fund for locally driven new Resource Development.

48. What Is Our Action Plan? Goal Three: Building on Foundations More for Maryland/Opportunity Compact • Private Investment: Invests seed capital in PROVEN strategies. • Public Savings: These investments reduce the need for “last resort” public programs and save the state money. • Public Reinvestment: As savings grow, a portion is reinvested in proven programs to expand prevention efforts and achieve results.

49. What Is Our Action Plan? Goal Three: Building on Foundations More for Maryland/Opportunity Compact • Continue Technical • Assistance • Timeline: ongoing

50. What Is Our Action Plan? Goal Three: Building on Foundations Renegotiated Community Partnership Agreements Invitation to Negotiate Integrated Systems of Care Negotiated Community Partnership Agreements • State Priority Result- Stable and Economically Independent Families • Indicator- OOH Placement • Strategies- • Wrap • Local Access Mechanism • Result- Locally Determined • Indicator- Locally Determined • Strategies- Locally Determined • Result- State Determined Priorities • Indicator- State Determined • Strategies- Locally Determined